Provider Demographics
NPI:1285833053
Name:P CENTRAL LLC
Entity Type:Organization
Organization Name:P CENTRAL LLC
Other - Org Name:FRIENDS-A MEETING PLACE
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-535-5800
Mailing Address - Street 1:PO BOX 6371
Mailing Address - Street 2:
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62202-6371
Mailing Address - Country:US
Mailing Address - Phone:618-271-7786
Mailing Address - Fax:618-222-2717
Practice Address - Street 1:716 NORTH COMPTON AVENUE
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103
Practice Address - Country:US
Practice Address - Phone:314-535-5800
Practice Address - Fax:314-535-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO709311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home